The primary goal of this project is to develop a training protocol to improve cochlear implant (CI) patients'abilities to perceive environmental sounds and improve speech perception. The secondary goal is to increase our understanding of the association between environmental sound perception and speech in CI patients. Specifically, based on earlier findings, we hypothesize that environmental sound training will lead to a generalizable improvement environmental sound perception as well as speech;while speech training will lead to an improvement in speech, but not in environmental sound perception. In both cases, training-related improvements are expected to be significantly greater than improvements due to passive learning through exposure. We further hypothesize that CI patients'ability to perceive speech and environmental sounds are closely related, and that this relationship is mediated largely by patients'general "higher-level" cognitive abilities and to a smaller extent by patients'basic sensory auditory abilities. These hypotheses will be tested using a pretest-posttest design and examining the differences in patient speech and environmental sound performance with and without training. In addition to environmental sounds and speech tests, patients will be administered tests of cognitive and basic auditory abilities that have been previously associated with speech and environmental sound performance in order to examine the involvement of these abilities in mediating the relationship between speech and environmental sounds. Perception of environmental sounds by CI patients has received little research attention despite its functional importance in patients'daily lives and patients'general enthusiasm about it. While most CI patients consider improved environmental sound perception an important benefit of implantation, their environmental sound performance remains considerably reduced despite extensive implant experience. Although environmental sound training has been recommended and is regularly used during early rehabilitation stages, this practice is not based on any empirical evidence that demonstrates the benefits of active environmental sound training. This proposal will address this limitation and provide a research-based foundation for developing effective and efficient rehabilitation strategies for CI patients that can increase implant benefits. Furthermore, if environmental sound abilities are closely associated with speech perception abilities, environmental sounds can be used for diagnostic and rehabilitation purposes with patients regardless of their familiarity with a specific language. Thus, the results of this study are expected to have important clinical impact. Relevance: This project will provide a framework for developing effective training methods to improve cochlear implant patients'abilities to perceive environmental sounds and improve speech. The use of environmental sounds as ecologically-relevant language-independent materials for diagnostic and rehabilitative purposes with cochlear implant patients will have important clinical implications for cochlear implant patients world-wide.